rapid pulse

pulse

1. Rate, rhythm, condition of arterial walls, compressibility and tension, and size and shape of the fluid wave of blood traveling through the arteries as a result of each heartbeat.

2. Rhythmical throbbing.

PULSES

3. Throbbing caused by the regular contraction and alternate expansion of an artery as the wave of blood passes through the vessel; the periodic thrust felt over arteries in time with the heartbeat. See: illustration

A tracing of this is called a sphygmogram and consists of a series of waves in which the upstroke is called the anacrotic limb, and the downstroke (on which is normally seen the dicrotic notch), the catacrotic limb.

The normal resting pulse in adults is between 60 and 100 beats per minute. The resting pulse is faster, for example, in febrile patients, anemic or hypovolemic persons, persons in shock, and patients who have taken drugs that stimulate the heart, such as theophylline, caffeine, nicotine, or cocaine. It may be slower in well-trained athletes; in patients using beta blockers, calcium channel blockers, or other agents; and during sleep or deep relaxation.

Patient care

In patients complaining of chest pain, pulses should be assessed in at least two extremities (e.g., both radial arteries). A strong pulse on the right side with a weak one on the left may suggest an aortic dissection or a stenosis of the left subclavian artery. Young patients with high blood pressure should have pulses assessed simultaneously at the radial and femoral artery because a significant delay in the femoral pulse may suggest coarctation of the aorta. Patients with recent symptoms of stroke or claudication should have pulses checked at the carotid, radial, femoral, popliteal, and posterior tibial arteries, to see whether any palpable evidence of arterial insufficiency exists at any of these locations. If a decreased pulse is detected, further evaluation might include ultrasonography or assessments of the ankle brachial index. Patients who are lightheaded or dizzy or who notice palpitations may have detectable premature beats or other pulse irregularities (e.g., the irregularly irregular pulse of atrial fibrillation).

abdominal pulse

A palpable pulse felt between the xiphoid process and the navel. This is produced by the pulse of the abdominal aorta.

asymmetrical radial pulse

basal pulse

bigeminal pulse

bisferiens pulse

A pulse marked by two systolic peaks on the pulse waveform. It is characteristic of aortic regurgitation (with or without aortic stenosis) and hypertrophic cardiomyopathy.

bounding pulse

A pulse that reaches a higher intensity than normal, then disappears quickly. Best detected when the arm is held aloft.

Synonym: collapsing pulse

brachial pulse

A pulse felt in the brachial artery.

See: Pulse: Brachial

capillary pulse

Visible inflow and outflow of blood from the nailbed. It is a finding in patients with aortic regurgitation when their fingernails or toenails are gently depressed by the examiner's finger. Synonym: Quincke's pulse

carotid pulse

A pulse felt in the carotid artery.

See: Pulse: Carotid

catacrotic pulse

A pulse showing one or more secondary waves on the descending limb of the main wave.

catadicrotic pulse

A pulse wave with two small notches on the descending portion.

central pulse

A pulse recorded near the origin of the carotid or subclavian arteries.

collapsing pulse

Corrigan's pulse

coupled pulse

dicrotic pulse

A pulse with a double beat, one heartbeat for two arterial pulsations, or a seemingly weak wave between the usual heartbeats. This weak wave should not be counted as a regular beat. It is indicative of low arterial tension and is noted in fevers.

dorsalis pedis pulse

A pulse felt over the dorsalis pedis artery of the foot.

See: Pulse: Dorsalis Pedis

entoptic pulse

Intermittent subjective sensations of light that accompany the heartbeat.

irregular pulse

irregularly irregular pulse

jugular pulse

Kussmaul's pulse

monocrotic pulse

A pulse in which the sphygmogram shows a simple ascending and descending uninterrupted line and no dicrotism.

nail pulse

A visible pulsation in the capillaries under the nails.

paradoxical pulse

A decrease in the strength of the pulse (and of systolic blood pressure) during inspiration, a condition that may be esp. prominent in severe asthma, cardiac tamponade, obstructive sleep apnea, croup, and other conditions that alter pressure relationships within the chest.

triphammer pulse

undulating pulse

unequal pulse

A pulse in which beats vary in force. Synonym: asymmetrical radial pulse

vagus pulse

A slow pulse resulting from parasympathetic influence on heart rate, mediated by the vagus nerve.

venous pulse

A pulse in a vein, esp. one of the large veins near the heart, such as the internal or external jugular. Normally it is undulating and scarcely palpable. In conditions such as tricuspid regurgitation, it is pronounced.

vermicular pulse

A small, frequent pulse with a wormlike feeling.

waterhammer pulse

A pulse with a powerful upstroke and then sudden disappearance; a hallmark of aortic regurgitation.

Signs to look for include heavy panting, profuse salivation, a rapid pulse, very red gums/tongue, lethargy, lack of co-ordination, reluctance or inability to rise after collapsing, vomiting, diarrhoea and loss of consciousness in extreme circumstances.

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